Fractionation and Localization of Distinct Frontal Lobe Processes: Evidence from Focal Lesions in Humans

Stuss, Donald T.; Alexander, Michael P.; Floden, Darlene; Binns, Malcolm A.; Levine, Brian; McIntosh, Anthony R.; Rajah, Natasha; Hevenor, Stephanie J.

doi:10.1093/acprof:oso/9780195134971.003.0025

Cited by 141 publications

(87 citation statements)

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“…These findings fit well with a large previous literature on the neuroanatomic localization of these specific executive functions. 13,19 A limitation of this study is that we were unable to completely rule out the effects of general cognitive dysfunction and disease severity. However, since the D-KEFS was designed (and validated) to isolate executive functions, 19,22 and imaging differences between the components were observed within the same patient group, we are confident that our results are valid.…”

Section: Principal Components Analysismentioning

confidence: 98%

“…13 Patients with FTD had high numbers of rule violations on the Tower Test compared to patients with Alzheimer disease and healthy controls, 14 and impaired performance on a sorting task associated with decreased left frontal lobe volume. 15 Performance on the Twenty Questions test has been shown to be impaired in patients with prefrontal cortex lesions, 16 and letter fluency is impaired in patients with left prefrontal 17 lesions.…”

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confidence: 99%

“…For one analysis (component 4), we used a left frontal region of interest (ROI) that we did not use for the other analyses. While this increases the power of this analysis over the others, the rationale was that previous findings have demonstrated that the left side is associated with executive functions, 13 and we wanted to power this analysis sufficiently to detect any associations between this component and the left frontal lobe. The left frontal ROI was selected from the WFU Pickatlas (http://fmri.wfubmc.edu/cms/software).…”

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confidence: 99%

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Executive dysfunction in frontotemporal dementia and corticobasal syndrome

et al. 2009

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Objective: To determine the pattern of executive dysfunction in frontotemporal dementia (FTD) and corticobasal syndrome (CBS) and to determine the brain areas associated with executive dysfunction in these illnesses. Method:We administered the Delis-Kaplan Executive Function System (D-KEFS), a collection of standardized executive function tests, to 51 patients with behavioral-variant FTD and 50 patients with CBS. We also performed a discriminant analysis on the D-KEFS to determine which executive function tests best distinguished the clinical diagnoses of FTD and CBS. Finally, we used voxel-based morphometry (VBM) to determine regional gray matter volume loss associated with executive dysfunction. Results:Patients with FTD and patients with CBS showed executive dysfunction greater than memory dysfunction. Executive function was better preserved in the patients with CBS than the patients with FTD with the exception of tests that required motor, visuospatial ability, or both. In patients with CBS, dorsal frontal and parietal and temporal-parietal cortex was associated with executive function. In FTD, tests with a language component (Verbal Fluency) were associated with left perisylvian cortex, sorting with the left dorsolateral prefrontal cortex, and reasoning (the Twenty Questions task) with the left anterior frontal cortex. The Twenty Questions test best distinguished the clinical diagnoses of CBS and FTD. Frontotemporal dementia (FTD) is a progressive neurodegenerative disease that primarily affects the frontal and anterior temporal lobes, resulting in changes in behavior, language, and cognition. Conclusions:1 Corticobasal syndrome (CBS) is a disorder characterized by progressive asymmetric apraxia and rigidity with other findings of cortical (e.g., alien limb, cortical sensory loss, myoclonus) and basal ganglia (e.g., bradykinesia and increased resistance to passive movement) dysfunction.2,3 Both disorders can be associated with pathologic tau aggregation.

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Section: Principal Components Analysismentioning

confidence: 98%

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confidence: 99%

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confidence: 99%

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Executive dysfunction in frontotemporal dementia and corticobasal syndrome

et al. 2009

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“…We identified the specific frontal regions that were damaged in each patient (Fig. 1) by superimposing their individual scans on a brain template based on previously published guidelines (Stuss et al, 2002). Lesions were drawn by the primary author, and for verification and replication, they were independently drawn by D.T.S.…”

Section: Participantsmentioning

confidence: 99%

Ventromedial Prefrontal Cortex Lesions Produce Early Functional Alterations during Remote Memory Retrieval

Gilboa¹,

Alain²,

He³

et al. 2009

J. Neurosci.

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We examined the role of ventromedial prefrontal cortex (VMPFC) in memory retrieval monitoring. Event-related potentials were recorded while patients with VMPFC lesions and matched controls viewed faces of personal acquaintances, and of famous and nonfamous people, and indicated whether they had personally encountered these individuals. Patients were more likely than controls to make both false positive and false negative errors. Both groups showed a large posterior negative wave peaking at ϳ170 ms after face onset (N170). In controls, the N170 was larger for both types of familiar faces, regardless of whether overt recognition occurred. Specifically, personal acquaintances that were erroneously judged as unfamiliar evoked the same electrophysiological response as those who were explicitly recognized. Patients' N170 was not modulated by familiarity suggesting VMPFC lesions disrupt early posterior memory-based preconscious cortical distinctions. Following the N170, there was a significant group difference over frontopolar scalp regions where patients were showing a smaller positive modulation at 230 -260 ms for all stimulus types. In patients this modulation correlated highly with reaction times of correct responses, suggesting this early frontal modulation is related to the ability to make rapid correct decisions about memory content. Group differences over anterior sites were also noted at 350 ms after stimulus, reflecting a large sustained negativity of patients' waveforms, equal across conditions. The findings are consistent with a hypothesis of frontally mediated dual-monitoring system. An early automatic (preconscious) component is followed by a late elaborate process. We hypothesize that when both components are damaged, confabulation may occur.

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“…De manera específica, es posible afirmar que en el paciente hay una afectación de la CPfdl y sus conexiones (circuitos dorsolaterales), área que corresponde a la porción más nueva del encéfalo y está relacionada con los procesos cognitivos de la CPf más complejos que el humano ha desarrollado a través de su evolución, como son la memoria de trabajo y las funciones ejecutivas (ffee) tales como fluidez (de diseño y verbal), solución de problemas complejos, flexibilidad mental, generación de hipótesis, estrategias de aprendizaje, seriación y secuenciación (Stuss et al, 2002). Además, representa el aspecto frío de los procesos cognitivos, los cuales contienen: razonamiento verbal, planeación, atención selectiva, resistencia a la interferencia, formación de conceptos, inhibición de impulsos y selección de estímulos (Zelazo y Müller, 2002); funciones que en su mayoría están alteradas en el paciente de este estudio, excepto la flexibilidad cognitiva, creación de estrategias de acción dirigidas a un fin, generación de hipótesis de clasificación y fluidez verbal, las cuales mostraron un desempeño dentro de la normalidad.…”

Section: Discussionunclassified

Perfil neuropsicológico en un paciente de 50 años con coinfección tuberculosis/VIH

2017

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El Virus de Inmunodeficiencia Humana (VIH) ataca al sistema inmunológico haciendo que este se debilite y no pueda defender al cuerpo de organismos infecciosos invasores; factor que es aprovechado por las enfermedades oportunistas, siendo la tuberculosis (TBC) una de las de mayor prevalencia en pacientes con VIH. La coinfección TBC/VIH, produce un deterioro progresivo del sistema inmune, secuelas neurológicas y alteraciones neuropsicológicas. El objetivo de este estudio es describir el perfil neuropsicológico de un hombre de 50 años con VIH y enfermedad oportunista (TBC). Para la evaluación neuropsicológica se utilizaron subpruebas del Test Barcelona, del proyecto NEURONORMA y de la BANFE 2. Los resultados sugirieron un síndrome prefrontal con mayor alteración de los circuitos dorsolaterales y orbitales. Este estudio estimula la realización de investigaciones que amplíen la información sobre las secuelas neuropsicológicas diferenciales del VIH y la TBC, así como las resultantes de su interacción.

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Fractionation and Localization of Distinct Frontal Lobe Processes: Evidence from Focal Lesions in Humans

Cited by 141 publications

References 0 publications

Executive dysfunction in frontotemporal dementia and corticobasal syndrome

Executive dysfunction in frontotemporal dementia and corticobasal syndrome

Ventromedial Prefrontal Cortex Lesions Produce Early Functional Alterations during Remote Memory Retrieval

Perfil neuropsicológico en un paciente de 50 años con coinfección tuberculosis/VIH

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